What does low blood sugar feel like?

I do not have diabetes and literally never thought that anything to do with blood sugar pertained to me or to ME/CFS (unless you also had co-morbid diabetes.) For the last several months I have been having episodes which I thought were either due to PEM or low blood volume and electrolytes. At the most extreme version, I would get shaky, dizzy, muscle twitches, mental confusion, hard to put words together, hard to walk straight, headaches, worsening of my breathing and even agitation.

When these episodes happen, I usually cannot think of what to do and my husband forces me to drink water or Pedialyte and take salt stick tablets which usually helps a lot. People asked me all kinds of questions (if I thought it was my thyroid or adrenals or a med side effect or autonomic, etc) and I am sure that all of these play a role.

Then @halcyon and @zzz (I hope you don't mind me mentioning you both) asked me if it could be due to low blood sugar and this had never occurred to me and I want to thank you both. My former naturopath had insisted I should not eat any sugar when she placed me on a strict diet back in June and lately I have barely been eating any food at all b/c it just feels like so much effort and energy that I do not have.

This morning I was having a similar episode plus was freezing cold and could not regulate my temperature which had gone down to 97.2. I thought about the blood sugar hypothesis (and have no way to measure it) but drank a cup of decaf Ginger tea with both sugar and honey in it and rested and then felt so much better that I was able to eat lunch and wrap all the Christmas gifts for a family get together on Sat and my temp had gone up to 97.7 and freezing feeling is gone.

Does this seem to match with low blood sugar and is that another sign of dysautonomia or of ME/CFS (in someone who is not diabetic?) Thanks for any info in advance and I appreciate and read everything!

I am not diabetic, but as many others I can get low blood sugar. I get shaky, feel dizzy, and feel an extreme need for liquids and food. Especially food which includes sugar. Usually happens when I am very hungry. If I get low blood sugar and eat a lot in a short period of time I feel much better after a few minutes.

I used to be hypoglycemic when I was younger, don't feel I am any more. Those symptoms absolutely can be low blood sugar. Do you get nausea? If I went without food for too long I would actually get sick.

If you can't get the energy, keep healthy snacks next to you and graze all day.

I am not diabetic, but as many others I can get low blood sugar. I get shaky, feel dizzy, and feel an extreme need for liquids and food. Especially food which includes sugar. Usually happens when I am very hungry. If I get low blood sugar and eat a lot in a short period of time I feel much better after a few minutes.

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@deleder2k I had assumed as you said that low blood sugar would equate with feeling hungry but I actually rarely ever feel hungry any more. If I eat a lot or eat too quickly I have trouble breathing so I don't get the benefit from it like you do.

I know there are glucose tablets for diabetes (but have never seen one and not sure if they are prescription or OTC?) and wondering if this could help me when I get this episode but not able to eat? I already take salt stick tablets so I may as well take sugar tablets too LOL.

I used to be hypoglycemic when I was younger, don't feel I am any more. Those symptoms absolutely can be low blood sugar. Do you get nausea? If I went without food for too long I would actually get sick.

If you can't get the energy, keep healthy snacks next to you and graze all day.

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@Strawberry How is hypoglycemic different than diabetic? What I mean is, do both equate to low blood sugar with the same symptoms (minus the high blood sugar portion?). Sorry if I am not asking this question clearly and I know what I am trying to ask in my own head!

I do get nausea but only occasionally now whereas prior to working with my former naturopath, I had nausea every single day and severe GI issues. She really helped me with this even though she didn't know much about CFS.

I rarely feel hungry before hypoglycemic symptoms set in. I get dizzy, light headed, shaky and head achey. Symptoms get worse the longer I go without eating. As soon as I eat, they go away. I have to eat every couple of hours (very frustrating) even though I am not at all hungry.

Diabetes is the body's inability to create... sugar (brain fart there...) Hypoglycemia is when the body doesn't get enough to maintain a proper level. If you can eat 6 small meals, or snack during meals, it might help. Sugar isn't what you need, although if you are too nauseous to eat, it will make the nausea pass.

@Comet How did you determine that was the problem? Did you do a test for low blood sugar? No doctor has ever mentioned this issue to me and every single one has told me to eat salt (but not sugar!). I literally cannot fathom eating every few hours and it is enough trying to force myself to drink fluids!

Is there something with CFS or dysautonomia that makes you no longer feel hunger or thirst? I eat twice a day now b/c I know I am supposed to but if I lived alone, I really don't think I would remember to do this. That must sound so weird.

@Comet How did you determine that was the problem? Did you do a test for low blood sugar? No doctor has ever mentioned this issue to me and every single one has told me to eat salt (but not sugar!). I literally cannot fathom eating every few hours and it is enough trying to force myself to drink fluids!

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Its more about carbs then sugar, just eating small meals more often with a good ratio of carbs, protein, and fat can help.

I'm still trying to figure out what causes my hypoglycemia but it has been a hallmark of my illness. If I don't eat every 3 hours I start to feel bad. As others have mentioned I rarely feel hunger before the onset of hypoglycemia.

One thing I definitely recommend is avoiding high carbs. Glucose tablets might get you out of a hypoglycemic state but real food would probably be a better idea.

Blood sugar homeostasis is mostly a feedback mechanism between the liver and the pancreas, but cortisol plays a part as well and I wonder if it may be part of the problem. Perhaps a cortisol spike is causing a blood sugar spike which then causes reactive hypoglycemia.

Is there something with CFS or dysautonomia that makes you no longer feel hunger or thirst? I eat twice a day now b/c I know I am supposed to but if I lived alone, I really don't think I would remember to do this. That must sound so weird.

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I'm not sure what causes it but I've completely lost my appetite as well. I just try to eat at the same time every day.

Perhaps a cortisol spike is causing a blood sugar spike which then causes reactive hypoglycemia.

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Is this something that the 24-hour saliva cortisol test would show? I am going to be repeating this test as soon as I have the energy to read the instructions and kit and get it done. What is the treatment for this?

I have to warn you about doctors and this subject. Try to avoid having them run a Glucose Tolerance Test, this can cause a crash simply due to metabolic stress without exercise. Hypoglycemia is a condition, not really a disease, and I have had ignorant doctors tell me to carry a candy bar with me in case I have an attack. This is a temporary solution which then precipitates yet another cycle of endocrine oscillations. Even when they see the results from a GTT indicating that your blood sugar goes too low, they don't really have anything to do about it except tell you not to do things resembling a GTT. Duh!

I have a diabetic friend who puts a cracker or hard candy under his tongue if he feels a crisis coming on. No prescription required. Under the tongue apparently absorbs the sugar much faster than eating and swallowing,

There was some question awhile ago that maybe my blood sugar was high, so I borrowed his handy-dandy blood tester instead of going to the lab, etc. Very clever devices, very easy to use.

@halcyon What types of things do you eat since you rarely feel hungry like me?

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For breakfast I usually have bacon and eggs. Lunch is usually a sandwich. Dinner is usually meat of some kind and vegetables (not starchy ones).

Is this something that the 24-hour saliva cortisol test would show? I am going to be repeating this test as soon as I have the energy to read the instructions and kit and get it done. What is the treatment for this?

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Probably not unless you happened to be in the middle of a cortisol spike when taking the sample. I don't even know if cortisol release would be spikey like this, I'm just theorizing ignorantly out loud.

I get these symptoms when I forget to eat, plus a routine blood test showed low blood sugar--after I had a snack while waiting for it. My doc's response was, "So eat something". A piece of fruit followed by some water and something with fat or protein--a food that takes a while to digest--usually reverses the symptoms, but it may take an hour. Don't try to do anything, just lie down and relax.

@Gingergrrl
I have (or at least had) hypoglycemia. I did have the 3 hour glucose tolerance test and my blood sugar dropped to 38. Then I got a test kit from the pharmacy and used to test it regularly.

What you don't want to do with hypoglycemia is to eat sugar, rather protein and complex carbohydrates every few hours. Eating only twice a day will increase hypoglycemia--if indeed you do have it.

If you don't want to try the glucose tolerance test in a lab, you can test yourself. You can get a test kit for about nothing (with rebates) at most pharmacies like CVS or Walgreens. If you do this, make sure your kit includes test strips--those are expensive but they give you some in most test kits.

Here is what you do: first thing in the a.m. drink one of the glucose drinks you can get at a pharmacy. Then test your blood sugar every hour for the next 3 (or 4) hours. Don't eat during this time. You will easily see if you are getting big drops in your blood sugar. I would get my biggest drop about 4 hours after eating. Then a feedback loop kicks in and raises your blood sugar. Hence it is important to eat frequently.

I have (or at least had) hypoglycemia. I did have the 3 hour glucose tolerance test and my blood sugar dropped to 38. Then I got a test kit from the pharmacy and used to test it regularly.

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Can you tell me (if you remember) what the normal number is supposed to be? I don't have a kit but am just curious.

What you don't want to do with hypoglycemia is to eat sugar, rather protein and complex carbohydrates every few hours. Eating only twice a day will increase hypoglycemia--if indeed you do have it.

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For a while I was just eating once a day and am forcing myself to eat twice. I can't imagine eating every few hours and everything tastes like cardboard to me. I actually think I might be sick right now on top of ME/CFS but am not sure.

I will think more about the test kits once I get back from my trip to see my doctor. Thanks again!

Low blood sugar is usually caused by eating less or later than usual, (my bolding) being more active than usual, or taking diabetes medicine that is not matched to your needs at that time.
Learn to recognize the symptoms of low blood sugar, which may include feeling nervous, shaky, sweaty, or tired. Symptoms may be mild at first but may worsen quickly if not treated. If you have signs of low blood sugar, test your blood right away. If your blood sugar level is less than 60 mg/dL, eat or drink a carbohydrate immediately,

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So it looks like eating less than usual and eating infrequently could be an issue here.

Sushi

P.S. Autonomic specialists also recommend eating many small meals rather than 2 or 3 normal size meals as a large meal will draw blood to the abdominal area and away from the brain and other organs.

For hypoglycemia, you don't have to eat a meal every few hours just something like a handful of nuts or some other protein or complex carb snack.